Blood test results - advice pls


We have just received the results of a Medichecks health check blood test on my husband. I wanted him to get it done (bear with me it is relevant!) because he had a cholesterol test about a year ago as part of a health check he gets with work and it was a little high. He also does a very stressful job with long hours and a long commute. He has always been quite resilient but has started having trouble sleeping and getting various physical ailments such as gum disease and recession, some Ibs type symptoms, and he is constantly exhausted. We have been putting this down to stress and lack of sleep. He doesn't have any other b12 deficiency symptoms.

Because of all of this I wanted him to get a blood test just to check everything was ok, there wasn't anything else going on/the stress and lack of sleep wasn't impacting his bloods.

Everything came back ok except b12 which was 233.5 (140-724). I know they are related so for completeness his folate is 9.08 (3.89-26.8).

Although in range I know his b12 is on the low side. As he doesn't really have b12 deficiency symptoms was going to just start him on 1000mcg oral b12 (methylcobalamin) with thornes b complex.

Would welcome views on this approach or whether we should be checking anything else.

Many thanks.

14 Replies

  • Hi MiniMum97 I'm not medically trained but as I understand it your husband's "IBS type symptoms" may put him "at risk" of developing a B12 Deficiency.

    Both the B12 and Folate readings are at the bottom end of the scale and if his doctor is not going to give him any treatment perhaps supplementing with both may be the way forward if for no other reason than to see if there is an improvement. Please do however start the B12 before the folic acid for a day or two.

    There will be other's on here who will be able to give more qualified advice.

  • Hi MiniMum

    The b12 although not very low is low enough to cause symptoms like fatigue and insomnia however you would need an active b12 to confirm deficiency/ PA. Is your husband a vegetarian/ vegan. Check to see if the blood test has a ferritin result and Vit D, not normally included in CB COUNT.

    Has the B12 been tested previously does it show a trend downwards?

  • Hi

    No he is not vege/vegan. Ferritin was ok at 127.7 (30-400). Not mid-range but his blood serum iron was slightly over range 33.29 (10.6-28.3) and T IBC 77.99 (41-77) so have assumed supplementation not needed or a good idea. Vit d 83.68 (50-200). Ok I thought as we are Just coming out of winter.

    Have put him on 5000iu twice a week as he is

    indoors all week and could be slightly higher. Going to retest levels in 4 months to check we are not overdoing anything.

    Should we get an active b12 done now? Is it ok to

    have started supplementing?

    B12 has not been tested before so we can't see if

    there has been a trend.

    Thank you

  • Hi

    Don't supplement if you are getting an active B12 as it will skew results however your gp may not agree to testing active b12 but you can get a finger price test through Blue Horizon medicals by post privately. Then once you have ascertained whether the b12 is due to Malabsorbsion meaning Pernicious Anemia then you will be able to start either tablet or injections. Take a look at the pernicious anemia society website for further support.

    Regards Mark

  • I think my question is does he need further testing given lack of symtoms. My guess would be that his stress and exhaustion are the likely causes for his slightly depleted b12?

  • We've already started supplementing but only for two days.

  • If he's not symptomatic and has in range b12 then mega doses are probably a bad idea as potentially it could trigger a functional deficiency.

    Why not just add a multivitamin with maybe 20-50 mcg of b12 in and see how things go.

    The 1000+ mcg are only needed if you can't absorb b12 efficiently.

  • Do you have any references that support what you say about high doses of b12 triggering a functional deficiency. I haven't heard this before and can't find anything online? Many thanks.

  • This is really Gambit62 's baby and here's a previous post on it.

    My limited understanding of it is the body responds to very high levels in some people by producing antibodies to b12 to block it at a cell level. Almost like an excess b12 protection mechanism.

    I don't believe it happens in many people though. It's quite rare. I've also only ever read about it on here. Everything else I've read would suggest there is little or no risk from high intake. It would seem to make sense and have credibility though when you consider how clever the body is at protecting its self.

  • please take a look at the pinned posts

    this link is particularly relevant


    and a reference on functional deficiency

  • as Steap says dosing with very high dose B12 tablets isn't recommended. Unless you have an absorption problem, at best, it is a waste of money.

    low B12 does make you more susceptible to stress and lowers the immune system but so will a lot of other things - including folate deficiency - though the results above aren't indicative of folate deficiency.

    People vary a lot in how much B12 they need in serum and how this relates to what is happening at the cell level. Its just one part of B12 metabolism.

    Did you have a full blood count - B12 deficiency causes a non-iron anaemia - macrocytosis/megaloblastic anaemia - in which red blood cells are rounder and larger than they should be and some of what you say above about iron is consistent with this - folate deficiency will also cause this anaemia.

    There are several forms of B12 and methyl isn't necessarily the best form - despite hype to the contrary.

  • Raised cholesterol is a low thyroid symptom. Before thyroid testing in the 70's - anyone with raised cholesterol had their thyroids treated 😊

    Thorough testing required and not just the TSH. Also the FT4 & FT3 along with BOTH anti- bodies TPO & Tg.

  • He had his TSH checked when his cholesterol was checked and it was under 1. He has increased exercise and made a few diet changes and his cholesterol has come down so think this is ok.

  • Most of the cholesterol is made in the body and very little to do with diet. Cholesterol is needed to make all hormones and needed for the brain - a huge part of which is cholesterol :-) Also needed to make VitD in the body - and it is the LDL that is involved in that process. Hence all those people on Statins now have low VitD and the accompanying illnesses. The new generation of Statins will now contain VitD - I wonder why !

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